Heel Spurs

  • Medical Author:
    William C. Shiel Jr., MD, FACP, FACR

    Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

  • Medical Editor: John P. Cunha, DO, FACOEP
    John P. Cunha, DO, FACOEP

    John P. Cunha, DO, FACOEP

    John P. Cunha, DO, is a U.S. board-certified Emergency Medicine Physician. Dr. Cunha's educational background includes a BS in Biology from Rutgers, the State University of New Jersey, and a DO from the Kansas City University of Medicine and Biosciences in Kansas City, MO. He completed residency training in Emergency Medicine at Newark Beth Israel Medical Center in Newark, New Jersey.

Heel spurs (calcaneal spurs) facts

  • A heel spur is a pointed bony outgrowth of the heel bone (the calcaneus bone).
  • The build-up of calcium deposits under the heel bone cause heel spurs.
  • Heel spurs under the sole of the foot (plantar area) are associated with plantar fasciitis (inflammation of the plantar fascia ligament at the bottom of the foot).
  • Heel pain is a common symptom of heel spurs.
  • Heel spurs and plantar fasciitis can occur alone or be related to underlying diseases.
  • Heel spurs are treated by anti-inflammatory medications, orthotics, and other measures that decrease the associated inflammation and avoid reinjury.

What is a heel spur? What are heel spur symptoms?

A heel spur is a pointed bony outgrowth of the bone of the heel (the calcaneus bone). Chronic local inflammation at the insertion of soft-tissue tendons or plantar fascia is a common cause of bone spurs (osteophytes). Heel spurs can be located at the back of the heel or under the heel, beneath the arch of the foot. Heel spurs at the back of the heel are frequently associated with inflammation of the Achilles tendon (tendinitis) and cause tenderness and heel pain made worse while pushing off the ball of the foot.

Picture of the metatarsal (foot) and calcaneus (heel) bones, the plantar fascia ligament, and the Achilles tendon of the lower leg and foot

How do heel spurs relate to plantar fasciitis? What causes heel spurs?

Heel spurs under the sole of the foot (plantar area) are associated with inflammation of the plantar fascia (plantar fasciitis), the "bowstring-like" ligament stretching underneath the sole that attaches at the heel. Plantar heel spurs cause localized tenderness and heel pain made worse when stepping down on the heel.

Heel spurs and plantar fasciitis can occur alone or be related to underlying diseases that cause arthritis (inflammation of the joints), such as reactive arthritis (formerly called Reiter's disease), ankylosing spondylitis, and diffuse idiopathic skeletal hyperostosis (DISH). It is important to note that heel spurs may cause no symptoms at all and may be incidentally discovered during X-ray exams taken for other purposes.

How do health care professionals diagnose heel spurs?

Heel spurs are diagnosed based on the history of heel pain and tenderness localized to the area of bony involvement. They are specifically identified when there is point tenderness at the bottom of the heel, which makes it difficult to walk barefoot on hard surfaces, like tile or wood floors. X-ray examination of the foot is used to identify the bony prominence (spur) of the heel bone (calcaneus).

Symptom of Heel Spurs

Heel Pain

Pain in the heel can result from a number of factors. Abnormalities of the skin, nerves, bones, blood vessels, and soft tissues of the heel can all result in pain. Because of walking and daily movement, we are always at risk for injury or trauma to the heel area.

What are heel spur treatment options? Are there any home remedies for heel spurs?

Heel spurs are treated by measures that decrease the associated inflammation and avoid reinjury. Local ice applications both reduce pain and inflammation. Anti-inflammatory medications, such as naproxen (Aleve) and ibuprofen (Advil), or injections of cortisone, are often helpful.

Orthotic devices or shoe inserts are used to take pressure off plantar spurs (donut-shaped insert), and heel lifts can reduce stress on the Achilles tendon to relieve painful bone spurs at the back of the heel. Similarly, sports running shoes with soft, cushioned soles can be helpful in reducing irritation of inflamed tissues from heel spurs. Infrequently, surgery is performed on chronically inflamed spurs.

What is the prognosis (outlook) of heel spurs?

The long-term outlook is generally good. The inflammation usually responds to conservative, nonsurgical treatments, like anti-inflammatory drugs and orthotics. Infrequently, surgical intervention is necessary.

Is it possible to prevent heel spurs?

Treating any underlying associated inflammatory disease can prevent heel spurs.

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Medically Reviewed on 10/29/2018
References
REFERENCES:

Johal, K.S., and S.A. Milner. "Plantar Fasciitis and the Calcaneal Spur: Fact or Fiction?" Foot Ankle Surg 18.1 Mar. 2012: 39-41.

Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.

"Plantar Fasciitis and Bone Spurs." June 2010. American Academy of Orthopaedic Surgeons. <https://orthoinfo.aaos.org/en/diseases--conditions/plantar-fasciitis-and-bone-spurs>.
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